Page 169 - 北京京煤集团总医院第十一届·2023学术年会论文集

北京京煤集团总医院 第十一届·2023 学术年会论文集

the condition of the skull base was determined. Different CT images and assisted localization
methods were used to define the supraorbital ethmoid chamber (SOEC), and the correlation between

the anterior ethmoid artery and Keros classification and SOEC was analyzed. Results: The results
of CT scan and reconstruction of sinuses showed that type Ⅰ anterior ethmoid artery accounted for
43.33% (52/120), type Ⅱ artery accounted for 18.33% (22/120), and type Ⅲ (anterior ethmoid artery
suspension rate) accounted for 38.34% (46/120). In Keros classification, type I accounted for 52.50%

(63/120), and the anterior ethmoid artery was suspended on 11 sides (17.46% (11/63). Type II was
38.33% (46/120), and the anterior ethmoidal artery was suspended on 24 sides (52.17% (24/46)).
Type III accounted for 9.17% (11/120), and the anterior ethmoidal artery was suspended on 11 sides
(100.00% (11/11). Spearson correlation analysis showed that Keros classification was moderately

positive correlated with anterior ethmoidal artery suspension (r=0.512,P ＜ 0.001). The 120
contained SOEC21, accounting for 17.50% (21/120). Anterior ethmoid artery suspended on 14 sides
(66.67%, 14/21); Without SOEC99 side, 82.50% (99/120); The anterior ethmoid artery was

suspended on 32 sides (32.32% (32/99)). The anterior ethmoidal artery suspension rate in the SOEC
2
group was significantly higher than that in the non-SOEC group (χ =8.644, P=0.003<0.05).
Conclusion: Anterior ethmoid artery suspension is closely related to increased Keros classification

and the presence of SOEC. Preoperative sinus CT can understand the relationship between the
position of anterior ethmoid artery and skull base, so as to reduce intraoperative injury of anterior
ethmoid artery.
[Keywords] Chronic sinusitis; Nasal endoscopic surgery; Anterior ethmoidal artery injury; Keros

typing; Anatomical relation
慢性鼻窦炎（chronic sinusitis，CRS）是一组以鼻腔及鼻窦炎症为主要特征的异质性疾

病，主要有鼻塞、流涕、头面部胀痛、嗅觉下降等临床表现，全球范围内 CRS 的患病率约
[1]
为 5%～12%，我国患病率约为 8% ，严重影响患者日常生活质量，甚至损害其身心健康。
鼻内镜手术是目前治疗 CRS 的重要手段，可减少对皮肤、黏膜和骨质结构的损伤，并可精
确显示鼻腔外侧壁和鼻窦解剖结构，利于围术期观察及分析，有效拓展了手术范围 [2-3] 。但

鼻内镜手术是一种精细化操作术式，对术野清晰度的要求很高，存在术中出血风险，进而导
致术野模糊，术中结构辨识不清，引起筛前动脉、眶纸板、视神经等结构损伤 [4-5] ,明确其与

颅底的位置关系，降低术中筛前动脉损伤风险具有重要意义。因此，有必要开展影像学评估，

分析筛前动脉与颅底之间的解剖关系。本文探讨鼻窦 CT 扫描及重建在明确筛前动脉与颅底
位置关系和降低鼻窦炎手术患者术中筛前动脉损伤风险中的应用价值，以期为临床鼻内镜手
术提供参考。

1 资料与方法

1.1 一般资料 选取 2021 年 8 月～2022 年 8 月我科收治入院的慢性鼻窦炎患者 60 例（120
侧），其中男 35 例（70 侧），女 25 例（50 侧），年龄 22～70 岁，平均（45.68±13.65）岁。

均行鼻窦 CT 扫描及重建，对其临床资料进行回顾性分析。纳入标准：①均确诊为慢性鼻窦

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